Summary, Conclusions, and Recommendations.
Substance abuse continues to be a major problem in child welfare, disrupting efforts to reunify children and families. The purpose of the PTP was to improve permanency outcomes, de- crease child safety issues, and support parents in entering and engaging in substance abuse treatment.
In spite of startup obstacles (e.g., hiring, changes in grant leadership, change in evaluator, unclear grant expectations) and external fluctuations in treatment availability and funding, the PTP was exceptionally successful with IDHW staff and participants. A new climate of understanding between substance abuse treatment providers and child welfare developed. As one substance abuse treatment provider stated, “It brought child protective counselors out of their building into our treatment center and strengthened our awareness of family issues.” SALs were successful in implementing motivational interviewing that had significant effects on parents’ willingness to recognize their AOD problems and initiate steps to overcome these problems.
The long-term outcomes of family reunification, child safety, and treatment entry and comple- tion are encouraging but not well-defined. An experimental design with a control group would give more definitive answers to cause and effect. As it stands, the long-term outcomes can be viewed as comparable for treatment entry and completion, or better for reunification and child safety, to other demonstration projects that incorporate substance abuse professionals within the child welfare system. Outcomes present an encouraging contrast to historically low suc- cess rates of clients in child welfare who have substance abuse issues.
The IDHW system experienced the importance of having certified substance abuse counselors closely connected to CPS to facilitate the disposition and treatment of parents who are af- fected by substance abuse. Before the project ended, a commitment was made to expand SALs and the PTP to all regions in the state. The project manager anticipates funding through a combination of federal dollars and other sources (e.g., TANF/SSBG, PSSF [Family Preserva- tion, Time-limited Family Reunification], and Substance Abuse funding.
Recommendations for improving long-term outcomes include:
Funding of more SALs, particularly in the rural areas of the state. Although the PTP has become the catalyst for new services for child welfare clients in Idaho, in this project the intervention was necessarily quite small. SALs averaged 2.33 face-to-face contacts and 1.67 telephone calls with participants. In the problematic life context of poor, uneducated young mothers abusing methamphetamines and without supporting resources, it is remarkable that this small intervention was associated with so many positive changes for IDHW, participants, and the substance abuse treatment providers.
The development of consistent substance abuse treatment funding and availability, particularly inpatient services, and a focus on the efficacy of substance abuse treatment for parents referred from child welfare.
The development of resources that focus on the serious co-occurring problems
g., mental illness, domestic violence, poverty) of most parents referred to child welfare, particularly parents with prior child welfare referrals. Services of SALS with such participants may need to be intensified, either through modified program services or greater judicial interaction that is similar to the family dependency drug court model.
Idaho Pre-Treatment Program